description: PAS constraints on Claim resource mandating support for elements relevant to the prior authorization request package_name: hl7.fhir.us.davinci derivation: constraint name: PASClaim type: Claim elements: extension: type: Extension short: Information about a hospital claim being requested. mustSupport: true url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter index: 0 slicing: slices: encounter: match: {} schema: type: Extension short: Information about a hospital claim being requested. mustSupport: true url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter index: 0 elements: value: choices: [valueReference] index: 2 valueReference: type: Reference choiceOf: value refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-encounter'] index: 3 identifier: {index: 4} supportingInfo: short: Send additional paperwork or supporting information for the request. This can be most commonly a DocumentReference profile although any type of information is allowed. array: true index: 5 slicing: slices: AdditionalInformation: match: {} schema: short: Send additional paperwork or supporting information for the request. This can be most commonly a DocumentReference profile although any type of information is allowed. array: true index: 5 elements: category: pattern: type: CodeableConcept value: coding: - {code: additionalInformation, system: 'http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes'} index: 6 timing: choices: [] index: 8 value: mustSupport: true choices: [valueReference] index: 10 valueReference: type: Reference mustSupport: true choiceOf: value refers: ['http://hl7.org/fhir/StructureDefinition/Resource', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference'] index: 11 required: [valueReference, value] MessageText: match: {} schema: short: Send text messages to the UMO. array: true index: 12 elements: category: pattern: type: CodeableConcept value: coding: - {code: freeFormMessage, system: 'http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes'} index: 13 timing: choices: [] index: 15 value: mustSupport: true choices: [valueString] index: 17 valueString: {type: string, mustSupport: true, choiceOf: value, index: 18} required: [valueString, value] diagnosis: short: 'Pertinent diagnosis information. NOTE: Only the first 12 diagnoses can be sent in the X12 request.' index: 19 extensions: recordedDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate', min: 0, max: 1, type: Extension, short: The date that a diagnosis was recorded. (HIxx-4), mustSupport: true, index: 21} elements: extension: index: 20 slicing: rules: open ordered: false discriminator: - {path: url, type: value} min: null slices: recordedDate: match: {url: null} schema: {type: Extension, short: The date that a diagnosis was recorded. (HIxx-4), mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate', index: 21} min: 0 max: 1 item: extensions: epsdtIndicator: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator', min: 0, max: 1, type: Extension, short: An indicator of whether early and periodic screen for diagnosis and treatment of children is involved., mustSupport: true, index: 22} nursingHomeResidentialStatus: url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus type: Extension short: A code specifying the status of a nursing home resident at the time of service. (SV209) mustSupport: true index: 23 elements: value: choices: [] index: 25 nursingHomeLevelOfCare: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare', min: 0, max: 1, type: Extension, short: 'A code specifying the level of care provided by a nursing home facility. (SV120, SV210)', mustSupport: true, index: 26} revenueUnitRateLimit: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit', min: 0, max: 1, type: Extension, short: The limit on the rate per unit of revenue for hospital accomodation. (SV206), mustSupport: true, index: 27} requestedService: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService', min: 0, max: 1, type: Extension, short: The details of the service being requested., mustSupport: true, index: 28} elements: extension: type: Extension short: An indicator of whether early and periodic screen for diagnosis and treatment of children is involved. mustSupport: true url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator index: 22 slicing: slices: epsdtIndicator: match: {} schema: {type: Extension, short: An indicator of whether early and periodic screen for diagnosis and treatment of children is involved., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator', index: 22} min: 0 max: 1 nursingHomeResidentialStatus: match: {} schema: type: Extension short: A code specifying the status of a nursing home resident at the time of service. (SV209) mustSupport: true url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus index: 23 elements: value: choices: [] index: 25 nursingHomeLevelOfCare: match: {} schema: {type: Extension, short: 'A code specifying the level of care provided by a nursing home facility. (SV120, SV210)', mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare', index: 26} min: 0 max: 1 revenueUnitRateLimit: match: {} schema: {type: Extension, short: The limit on the rate per unit of revenue for hospital accomodation. (SV206), mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit', index: 27} min: 0 max: 1 requestedService: match: {} schema: {type: Extension, short: The details of the service being requested., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService', index: 28} min: 0 max: 1 category: {short: 'Since PAS requests only have item-level information, a category is required for conformance with the X12 278 request.', mustSupport: true, index: 29} unitPrice: {mustSupport: true, index: 30} required: [category] package_version: pas-2.0.1 extensions: encounter: url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter type: Extension short: Information about a hospital claim being requested. mustSupport: true index: 0 elements: value: choices: [valueReference] index: 2 valueReference: type: Reference choiceOf: value refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-encounter'] index: 3 class: profile kind: resource url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim base: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base version: 2.0.1 required: [identifier]